Provider Demographics
NPI:1730945536
Name:TONG, DANELLE IRENE
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:IRENE
Last Name:TONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 SIDNEY ST
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5944
Mailing Address - Country:US
Mailing Address - Phone:307-374-1489
Mailing Address - Fax:
Practice Address - Street 1:514 SIDNEY ST
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5944
Practice Address - Country:US
Practice Address - Phone:307-374-1489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator